Eric J. Lund, Psy.D., ABPP, BCBA and Christopher VanDyke, MS

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Autism has risen to almost epidemic proportions in the United States with current estimates suggesting that the probability of having a child born with autism is about 1 out of every 166 births. In reaction to this startling number various treatment programs have been developed to address the needs of this growing population. Starting with the ground breaking work of Dr. Ivar Lovaas at UCLA behaviorists have been on the frontline fighting to remediate deficits related to a diverse set of problems associated with the autism spectrum disorders. Read More...

Covering the vast amount of research on autism is beyond the scope of this book. There are texts such as the Handbook of Autism and Pervasive Developmental Disorders (Volkmar, Paul, Klin & Cohen, 2005) and The Neurobiology of Autism (Bauman & Kemper, 2005) which provide a fairly comprehensive overview of what is known and not known about autism. There has been an enormous amount of research related to autism which often leads to unsupported or minimally supported results. We have tried to focus here on research which consistently supports certain conclusions about autism.
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In this chapter the goal is to outline certain behavioral principles and give basic background information about behaviorism to help the reader better understand what guides our thinking about treatment. We will cover respondent conditioning, operant conditioning, social learning, and new information on derived relational responding. We also provide an outline of applied behavior analysis which is the guiding therapeutic method that we use to progress a child’s development. Read More...

In this chapter we discuss developmental patterns from a behavioral perspective. Read More...

This chapter addresses the development of environmental acceptance. Read More...

At this point, we have a child that is moving toward being comfortable with the sensations coming from within, as well as into the body from the world. The child is usually comfortable and can self-soothe, and the caregiver has many strategies for calming the child when he/she is upset. The child’s newfound ability to somewhat manage their sense of self-security allows the child to begin to expand their interactions with the surrounding environment in a more sophisticated manner than was possible before. For example, instead of isolating from other people, the self-secure child has allowed the caregiver/therapist to build up many positive associations related to their presence and has become aware that such people can be very enjoyable to be around. In essence, the self-secure child is now beginning to develop an emotional attachment to the caregiver/therapist.. Read More...

So far we have addressed only the very basic foundation of successful therapy and interactions with children with ASD – developing a sense of security and comfort in any given environment. We will continue to focus on increasing environmental acceptance all through the process of therapy with a child. What is the next key foundational skill? After a child has a sense of security in his/her environment we need to expand the focus of therapy. The building block of increased environmental security will continue as a primary focus throughout therapy and hopefully the child’s life. As this base of security and relating is being established, we must add strategies to build self-initiation, purposeful nonverbal signaling, and an expanded ability to emotionally engage and relate to other people in the environment. Read More...

Here we will teach the child to relate and respond to objects, sounds and movements. Objects are taught through puzzles, matching, block design, sorting, patterning, and ordering by size. Sounds are taught through contagion, labeling, affect matching, animal sounds, preschool songs and environmental exposure. The child is taught to relate and respond to movements through motor imitation. The first three basic categories of programs are Auditory/Verbal Discrimination, Motor Imitation, and Visual/Spatial Discrimination. Auditory/Verbal discrimination leads to verbal responsiveness. Motor imitation leads to vocal imitation, and visual/spatial discrimination leads to receptive labels. Verbal responsiveness and vocal imitation lead to Requesting. Receptive labels and Verbal Responsiveness lead to Expressive Labels.
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At this point the child has had a lot of exposure to auditory/verbal stimuli, experience with motor imitation, and experience discriminating visual/spatial objects. The next step involves teaching the child to be responsive to verbalizations. The child in this stage is rewarded for attending to, discriminating between and responding to verbal requests. We begin by teaching the child to orient to a speaker when the child’s name is called. In beginning programs the therapist learned how to make the child happy.
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Up to this point we have focused largely on discrimination abilities between objects and sounds in the world and receptive language ability. The child has also started to imitate verbal sounds. As the child’s verbal ability grows we can start to work more on expressive language abilities. While the child is beginning to use language through requesting and expressive labels, his/her desire for objects and actions continues to be a major motivating force to help us increase the behavior of requesting and expressive labeling.
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Up to this point the child has learned to comfort him/herself. He/she has learned how to signal others and problem solve behavioral contingencies. The child can differentiate objects in his/her environment and has learned to respond to labels and verbal requests and to imitate motor action and verbalizations. The child has also learned to expressively label their world and to request objects, people and activities.
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This chapter discusses strategies to increase abstract language. Read More...

A child’s patterns of attending often make the process of learning difficult. Models of attentional processing are extensive but often difficult to put into practical clinical application. I will describe a model of attention, to use as a heuristic, for clinicians while working with a child with autism to help guide them in dealing with attention issues.
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Self-soothing repetitive behavior is often referred to as self-stimulatory behavior or stimming. We use the term self-soothing repetitive behavior to more directly describe what the child is doing. The first task that a child must overcome in this world is to be comfortable with the sensory stimulation coming in to the brain, from the world, and from his/her own body. The child learns to self-regulate or become comfortable with the sensory stimulation coming in.
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Autism is considered to be one of the most severe forms of childhood neuropsychiatric disorders. Autistic disorders involve impairment in social reciprocity & communication, often together with cognitive deficits (Cook and Leventhal, 1992). Neuropsychological profiles of children with cognitive mental retardation differ from those of children with autism. Children with autism often show strengths in visual-spatial processing ability and remote memory with more significant problems in the area of verbal comprehension. Children with cognitive mental retardation usually show fairly consistent delays in all areas of cognitive performance (Dawson & Castelloe, 1995).
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References
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